Archive 2011 - No 2

The study of psychotropic prescribing habits of professional colleagues has become important because of the widespread and unrestricted use of these drugs and the adverse effects of their long-term use. Furthermore, the irrational use of benzodiazepines and prophylactic use of antiparkinsonian drugs is a common practice in psychiatric, teaching and general hospitals especially in developing countries. This study aims to assess the psychotropic prescribing practice of doctors in the University of Maiduguri Teaching Hospital.

INTRODUCTION: Throughout the world epilepsy is a major neurologic disease with considerable personal and social impact. It constitutes the commonest non-infectious disease of the nervous system that brings the Africans to the hospital. The present study set out to describe the clinical profile of epilepsy in Kano, Northwestern Nigeria.
MATERIALS AND METHODS: The present study was based on the systematic study of consecutive epileptic patients seen at the adult Neurology Clinic of Aminu Kano Teaching Hospital and Murtala Specialist Hospital Kano
over a period of 3 years. Data was collected using a structured questionnaire, which was pretested for clarity, and it was administered by a neurologist and resident doctors, EEGs were obtained and neuroimaging was done where necessary. Analysis of data was done using a statistical software package SPSS version16.
RESULTS: Two hundred and ten patients comprising one hundred and twenty four (59 %) males and eighty six (41%) females were studied. The median age of the male patients was 34 years (range: 17 -77 years) and the median age of the female patients was 35 years (range: 14 -85 years). Eighty eight (41.9%) of the patients had complex partial seizures while eighty three (39.5%) had primarily generalized tonic clonic seizures. The most common (55.6%) aura and automatism encountered in the patients with complex partial seizure were sensory, oro-alimentary respectively. Neurologic deficit was much more likely to be found in simple partial seizure compared to primarily generalized seizure with an odd ratio of 69.4. The most common etiological factors identified on neuroimmaging were cerebral infarcts (4.8%) and tumors (3.3%). Abnormality on neuroimmaging was much more likely to be found in simple partial seizure compared to primarily generalized seizure, odd ratio was 33.9. Abnormal EEG was recorded in 60% of the patients. At presentation, 44.3 % were already on traditional or spiritual mode of treatment. Subsequently, all the patients had anticonvulsants, 55.7% had adequate seizure control. No mortality was recorded during the study period.
Conclusion: In our study, Complex partial and generalized tonic-clonic seizures appeared to be the most common epileptic seizure type seen in Kano. Cerebral infract and tumour appeared to be the most common etiologic factors among subset of patients with symptomatic seizure. Majority of the patients would have sought spiritual or traditional treatment before coming to the hospital stressing the need for education.

Background: Injury is a global problem, although its threats on children in the developing countries are over shadowed by infectious diseases and malnutrition. Our ordinary environment (home, road/street, playground) represent various kind of risks where injuries are sustained, which contribute to childhood morbidity and mortality.
OBJECTIVES: The aim of the study was to ascertain the pattern of injuries sustained in our environment and proffer preventive measures.
Methods: The case notes of children admitted and managed for injuries in the University of Maiduguri Teaching Hospital between June 2002 and May 2007 were retrospectively studied.
Results: A total of 393 patients were studied, 165(42%) of the children were below 4years of age. There were more males than females in the ratio of 2.2:1, home192 (48.9%) and the road/street 150(38.2%) were the commonest places of injury. Road traffic accidents 138(35.1%) and burns 135(34.4%) were the main cause of injuries, while the extremities were the commonest sites.
Conclusion: Home safety education for parents and care givers about child hazards will go a long way in reducing accidents in the home, while adequate measures to prevent road traffic accidents is desirable.

BACKGROUND: profound bilateral sensorineural hearing loss has being a major hearing disability in children worldwide, most especially in tropical sub-Saharan Africa. Various aetiological factors ranging from congenital causes, maternal and childhood infections to the use of ototoxic drugs have been implicated. This study aims at highlighting the various aetiological factors and the pattern of profound bilateral sensorineural hearing loss in children.
METHODOLOGY: Case files of two thousand, seven hundred and sixty-one children aged 1-15yrs who presented to our facilities during the study period, with all types and grades of hearing loss were reviewed. Out of this four hundred and thirty-six (436) were children that presented with profound bilateral sensorineural hearing loss; the obtained data was documented on a structured pro forma questionnaire for statistical analysis. The variables include the socio-demographic data of the children, the various aetiological factors of hearing loss at presentation, laboratory investigations; and detailed clinical and audiological assessment.
RESULTS: Among the 2761 case files of children with both conductive and sensorineural hearing loss that was retrieved, 436(15.8%) with profound bilateral sensorineural hearing loss was analyzed. There were 264 males and 172 females, with M: F =3:2, age-group of 1-4yrs was found to be the most affected with 184.0(42.2%).Generally more males affected than females. There was a decrease in the frequency of profound sensorineural hearing loss with increasing age. Unknown (idiopathic) causes were found to be the commonest aetiological factor with 144.0 (33.0%), this was followed by measles and meningitis infections with 21.6%, and 14.4% respectively.
CONCLUSION: Profound bilateral sensorineural hearing loss still remains a major childhood disability in our environment. More efforts should be made towards providing facilities for effective virology and genetic studies in our health care institutions. Intensive immunization campaign, especially against measles and meningitis should be emphasized nationally.